Ruxandra-Patricia Nitica, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu
Background. The parvovirus B19 (B19V) belongs to the Parvoviridae family, genus Erythrovirus, and is a virus that causes a common childhood disease called erythema infectiosum, also largely known as the fifth childhood disease. The clinical appearance is marked by the “slapped cheek” facies and an erythematous rash localized mainly on the extremities and on the trunk. Most people gain immunity during childhood, and when it occurs in pregnancy in non-immunized women, there are some serious complications for the fetus that can occur. B19V infection in pregnancy can conduct to fetal loss or severe hydrops fetalis, due to the risk of vertical transmission to the fetus and the virus tropism for the erythropoietic fetal stem cells with subsequent cell destruction and fetal anemia. Invasive treatment, as intrauterine fetal transfusion, is necessary for the cases of severe fetal anemia with good survival rates afterwards. The purpose of this review is to update the current knowledge regarding the best management of severe fetal anemia and other complications related to B19V infection in pregnancy, based on the latest data from literature and guidelines. Methods. Electronic research for relevant articles published in the last years was made, with the usage of PubMed, Medline, Cochrane Data Base, and the current international guidelines promoted by the Obstetrics and Gynecology Societies. Results and conclusions. The importance of prenatal detection of non-immunized women by serologic testing for parvovirus B19 should not be overlooked, and subsequent follow-up should be recommended in order to lower the incidence of fetal complications associated with developing the disease in pregnancy, especially during epidemics. In case of P19V infection in pregnancy, serial ultrasounds and lab tests should be performed in order to determine the impact on the fetus and the apparition of fetal hydrops. The future moms who are not immunized to B19V should be advised about the risk of vertical transmission and the associated fetal sequelae that can occur. Assessment for maternal disease and for fetal impairment has to become a priority when there are signs of primary infection in pregnancy.
{"title":"Parvovirus infection in fetal life. Case report and recent literature updates","authors":"Ruxandra-Patricia Nitica, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu","doi":"10.37897/rjid.2022.1.6","DOIUrl":"https://doi.org/10.37897/rjid.2022.1.6","url":null,"abstract":"Background. The parvovirus B19 (B19V) belongs to the Parvoviridae family, genus Erythrovirus, and is a virus that causes a common childhood disease called erythema infectiosum, also largely known as the fifth childhood disease. The clinical appearance is marked by the “slapped cheek” facies and an erythematous rash localized mainly on the extremities and on the trunk. Most people gain immunity during childhood, and when it occurs in pregnancy in non-immunized women, there are some serious complications for the fetus that can occur. B19V infection in pregnancy can conduct to fetal loss or severe hydrops fetalis, due to the risk of vertical transmission to the fetus and the virus tropism for the erythropoietic fetal stem cells with subsequent cell destruction and fetal anemia. Invasive treatment, as intrauterine fetal transfusion, is necessary for the cases of severe fetal anemia with good survival rates afterwards. The purpose of this review is to update the current knowledge regarding the best management of severe fetal anemia and other complications related to B19V infection in pregnancy, based on the latest data from literature and guidelines. Methods. Electronic research for relevant articles published in the last years was made, with the usage of PubMed, Medline, Cochrane Data Base, and the current international guidelines promoted by the Obstetrics and Gynecology Societies. Results and conclusions. The importance of prenatal detection of non-immunized women by serologic testing for parvovirus B19 should not be overlooked, and subsequent follow-up should be recommended in order to lower the incidence of fetal complications associated with developing the disease in pregnancy, especially during epidemics. In case of P19V infection in pregnancy, serial ultrasounds and lab tests should be performed in order to determine the impact on the fetus and the apparition of fetal hydrops. The future moms who are not immunized to B19V should be advised about the risk of vertical transmission and the associated fetal sequelae that can occur. Assessment for maternal disease and for fetal impairment has to become a priority when there are signs of primary infection in pregnancy.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49063897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ocular toxoplasmosis is a retinochoroiditis caused by Toxoplasma gondii infection, the most common cause of posterior infectious uveitis worldwide. Main features: it is a unilateral recurrent focal retinochoroiditis infection, with early manifestation after primary systemic infection, or with late manifestation after reactivation of intraretinal infectious cysts. The diagnosis is mainly clinical, being paraclinical supported by laboratory tests. Associated features: the most common is a unilateral focal ocular pathology, with multiple and bilateral active lesions occurring in a recently acquired infection or in immunocompromised patients. Ocular toxoplasmosis is characterized by posterior, intermediate, and anterior ocular damage; is a retinochoroiditis infection with significant involvement of the vitreous, with increased inflammation, retinal vasculitis, optic disc edema and anterior uveitis. Therapeutic management includes antiparasitic medication and corticosteroid therapy. Regarding pregnancy, it is essential to screen and capture the moment of maternal acute infection during pregnancy in patients with negative IgGs in order to treat the infection, to minimize or even prevent transplacental passage.
{"title":"Ocular toxoplasmosis – case report and literature review","authors":"Irina-Cristina Barca","doi":"10.37897/rjid.2021.4.6","DOIUrl":"https://doi.org/10.37897/rjid.2021.4.6","url":null,"abstract":"Ocular toxoplasmosis is a retinochoroiditis caused by Toxoplasma gondii infection, the most common cause of posterior infectious uveitis worldwide. Main features: it is a unilateral recurrent focal retinochoroiditis infection, with early manifestation after primary systemic infection, or with late manifestation after reactivation of intraretinal infectious cysts. The diagnosis is mainly clinical, being paraclinical supported by laboratory tests. Associated features: the most common is a unilateral focal ocular pathology, with multiple and bilateral active lesions occurring in a recently acquired infection or in immunocompromised patients. Ocular toxoplasmosis is characterized by posterior, intermediate, and anterior ocular damage; is a retinochoroiditis infection with significant involvement of the vitreous, with increased inflammation, retinal vasculitis, optic disc edema and anterior uveitis. Therapeutic management includes antiparasitic medication and corticosteroid therapy. Regarding pregnancy, it is essential to screen and capture the moment of maternal acute infection during pregnancy in patients with negative IgGs in order to treat the infection, to minimize or even prevent transplacental passage.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47929486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Zugravu, T. Salmen, I. Ducu, B. Mihai, Vlad Dima, C. Berceanu, A. Bohîlțea, Smaranda Neagu, N. Bacalbaşa, I. Bălescu, R. Bohîlțea
Aim. Because the COVID-19 pandemic is a topic of interest in the literature due to its information dynamics and, also, to its impact on the population health status; we wanted to highlight the connection between pandemic and lifestyle, with an emphasis on eating habits. Material and methods. A questionnaire with 20 items about sociodemographic data and information about eating habits was distributed. Results. Data collected reflected how COVID-19 pandemic influenced the employment status, level of income, smoker status, consumption of fruits, vegetable, candies, sweets, chocolate and fast-food of the respondents. The reported dietary changes were reflected both positively by more regular meals, a slight increase in the consumption of fruits and vegetables, lower consumption of fast food and higher cooked food, and negatively by a higher intake of sweets, candies and chocolate and as a result of an increasing in the habit of compulsive eating. Conclusion. The trait that easily weighed on all the activities of this period is the perceived level of stress and anxiety.
{"title":"The influence of the COVID-19 pandemic on lifestyle – a pilot study","authors":"C. Zugravu, T. Salmen, I. Ducu, B. Mihai, Vlad Dima, C. Berceanu, A. Bohîlțea, Smaranda Neagu, N. Bacalbaşa, I. Bălescu, R. Bohîlțea","doi":"10.37897/rjid.2021.4.5","DOIUrl":"https://doi.org/10.37897/rjid.2021.4.5","url":null,"abstract":"Aim. Because the COVID-19 pandemic is a topic of interest in the literature due to its information dynamics and, also, to its impact on the population health status; we wanted to highlight the connection between pandemic and lifestyle, with an emphasis on eating habits. Material and methods. A questionnaire with 20 items about sociodemographic data and information about eating habits was distributed. Results. Data collected reflected how COVID-19 pandemic influenced the employment status, level of income, smoker status, consumption of fruits, vegetable, candies, sweets, chocolate and fast-food of the respondents. The reported dietary changes were reflected both positively by more regular meals, a slight increase in the consumption of fruits and vegetables, lower consumption of fast food and higher cooked food, and negatively by a higher intake of sweets, candies and chocolate and as a result of an increasing in the habit of compulsive eating. Conclusion. The trait that easily weighed on all the activities of this period is the perceived level of stress and anxiety.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41932459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Grigoriu, R. Bohîlțea, Gina Călinescu, A. Bălan, Doru Campean, I. Horhoianu, T. Georgescu, B. Mihai, Irina Maria Vlădăreanu, N. Bacalbaşa
Vertical mother-to-fetus transmission of hepatitis B virus (HBV) is a concern of public health global policies. The transmission rate can be substantially influenced by the good function of the maternal screening programs and by the vaccination of newborns as well. Also, the appropriate treatment of pregnant women and the administration of anti-HBV immunoglobulin immediately after birth come up with the decrease of HBV transmission rate. Acute viral hepatitis during pregnancy constitutes the main cause of jaundice recognized in pregnant women. It has generally a mild course during pregnancy, without significantly influencing the health state of the mother. In the context of immunological adaptation in pregnancy, the condition of the pregnant woman with chronic HBV infection without notable hepatic dysfunction generally has a good evolution. However, there are some possible clinical consequences like hepatic flares and progression of liver disease. The paper presents a review of literature and guideline proposals to prevent vertical transmission of hepatitis B virus and to provide the best possible care for pregnant women with hepatitis B infection.
{"title":"Hepatitis B in pregnancy – Review of literature and guideline proposal","authors":"C. Grigoriu, R. Bohîlțea, Gina Călinescu, A. Bălan, Doru Campean, I. Horhoianu, T. Georgescu, B. Mihai, Irina Maria Vlădăreanu, N. Bacalbaşa","doi":"10.37897/rjid.2021.4.2","DOIUrl":"https://doi.org/10.37897/rjid.2021.4.2","url":null,"abstract":"Vertical mother-to-fetus transmission of hepatitis B virus (HBV) is a concern of public health global policies. The transmission rate can be substantially influenced by the good function of the maternal screening programs and by the vaccination of newborns as well. Also, the appropriate treatment of pregnant women and the administration of anti-HBV immunoglobulin immediately after birth come up with the decrease of HBV transmission rate. Acute viral hepatitis during pregnancy constitutes the main cause of jaundice recognized in pregnant women. It has generally a mild course during pregnancy, without significantly influencing the health state of the mother. In the context of immunological adaptation in pregnancy, the condition of the pregnant woman with chronic HBV infection without notable hepatic dysfunction generally has a good evolution. However, there are some possible clinical consequences like hepatic flares and progression of liver disease. The paper presents a review of literature and guideline proposals to prevent vertical transmission of hepatitis B virus and to provide the best possible care for pregnant women with hepatitis B infection.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46640719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Cigăran, N. Gică, R. Botezatu, A. Ciobanu, B. Cimpoca-Raptis, Mihaela Demetrian, C. Gică, G. Peltecu, A. Panaitescu
The overall risk of methicillin-resistant Staphylococcus aureus (MRSA) in obstetric populations is unknown. MRSA infection incidence has increased in pregnant women and neonates even if prevention techniques of MRSA have improved. MRSA infections affect both mothers and their infants. MRSA is the most common pathogen responsible for postpartum mastitis. There are also other postpartum infections with MRSA such as cellulitis, pelvic thrombophlebitis, pneumonia, septicemia, cesarean wound infections, episiotomy infections and urinary tract infections. The objectives of this review were to identify the most frequent risk factors for postpartum MRSA infection and to determine the frequency of antibiotic-resistant Staphylococcus aureus infections after delivery. A literature review was conducted using PubMed and we used the following key words “MRSA infection in postpartum”, “risk factors for postpartum MRSA infection”. We are included in our review 27 articles from the last 20 years which presented rare cases of MRSA infection in postpartum and those which identified the risk factors of this infection after delivery. Infections with MRSA appear to be more frequent among pregnant women colonized with MRSA. Early identification of MRSA, early diagnosis and appropriate treatment of infection is mandatory for a good prognosis. By now, vigilance and effective MRSA prevention strategies are considered essential to limit the spread and infection.
{"title":"Methicillin-resistant Staphylococcus aureus infections in postpartum period","authors":"R. Cigăran, N. Gică, R. Botezatu, A. Ciobanu, B. Cimpoca-Raptis, Mihaela Demetrian, C. Gică, G. Peltecu, A. Panaitescu","doi":"10.37897/rjid.2021.4.3","DOIUrl":"https://doi.org/10.37897/rjid.2021.4.3","url":null,"abstract":"The overall risk of methicillin-resistant Staphylococcus aureus (MRSA) in obstetric populations is unknown. MRSA infection incidence has increased in pregnant women and neonates even if prevention techniques of MRSA have improved. MRSA infections affect both mothers and their infants. MRSA is the most common pathogen responsible for postpartum mastitis. There are also other postpartum infections with MRSA such as cellulitis, pelvic thrombophlebitis, pneumonia, septicemia, cesarean wound infections, episiotomy infections and urinary tract infections. The objectives of this review were to identify the most frequent risk factors for postpartum MRSA infection and to determine the frequency of antibiotic-resistant Staphylococcus aureus infections after delivery. A literature review was conducted using PubMed and we used the following key words “MRSA infection in postpartum”, “risk factors for postpartum MRSA infection”. We are included in our review 27 articles from the last 20 years which presented rare cases of MRSA infection in postpartum and those which identified the risk factors of this infection after delivery. Infections with MRSA appear to be more frequent among pregnant women colonized with MRSA. Early identification of MRSA, early diagnosis and appropriate treatment of infection is mandatory for a good prognosis. By now, vigilance and effective MRSA prevention strategies are considered essential to limit the spread and infection.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42158832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. I. Trifonescu, V. Molagic, C. Tilișcan, Oana Ganea, Gelal Aytu Turan, Laurențiu Stratan, A. Vișan, Nicoleta Iftode, S. Aramă, V. Aramă
Introduction. COVID-19 is a viral infection with a variable clinical spectrum, ranging from asymptomatic carrier state to severe pneumonia. It is associated with a variety of complications, including musculoskeletal abnormalities. Whereas myalgia is a common clinical finding at these patients, only a few cases of COVID-19-associated rhabdomyolysis have been described in the literature. Case presentation. We describe the case of a 42-year old male confirmed with SARS-CoV-2 infection who presented to the emergency department with an 11-day evolution of dyspnea, cough, fatigue, myalgia and hyperchromic urine. The physical examination revealed dyspnea and an oxygen saturation of 87% while breathing ambient air, being otherwise normal. Blood tests showed neutrophilia, increased inflammatory markers, COVID-19 associated coagulopathy and elevation of muscular enzymes creatine-kinase and myoglobin. The chest computer tomography was consistent with mixed pneumonia, distributed in all pulmonary segments and the case was interpreted as a severe form of SARS-CoV-2 infection, associated with acute respiratory failure and rhabdomyolysis. Upon treatment (Enoxaparin, Aspirin, Dexamethasone, Favipiravir, oxygen administered by face mask, fluid resuscitation), his condition considerably improved, along with the laboratory findings, and he was discharged, without developing acute kidney injury or other complications related to rhabdomyolysis during his admission. Conclusion. COVID-19 patients can develop rhabdomyolysis, which can result in life-threating complications.
{"title":"Rhabdomyolysis in a hospitalized patient with COVID-19 – case report","authors":"M. I. Trifonescu, V. Molagic, C. Tilișcan, Oana Ganea, Gelal Aytu Turan, Laurențiu Stratan, A. Vișan, Nicoleta Iftode, S. Aramă, V. Aramă","doi":"10.37897/rjid.2021.4.7","DOIUrl":"https://doi.org/10.37897/rjid.2021.4.7","url":null,"abstract":"Introduction. COVID-19 is a viral infection with a variable clinical spectrum, ranging from asymptomatic carrier state to severe pneumonia. It is associated with a variety of complications, including musculoskeletal abnormalities. Whereas myalgia is a common clinical finding at these patients, only a few cases of COVID-19-associated rhabdomyolysis have been described in the literature. Case presentation. We describe the case of a 42-year old male confirmed with SARS-CoV-2 infection who presented to the emergency department with an 11-day evolution of dyspnea, cough, fatigue, myalgia and hyperchromic urine. The physical examination revealed dyspnea and an oxygen saturation of 87% while breathing ambient air, being otherwise normal. Blood tests showed neutrophilia, increased inflammatory markers, COVID-19 associated coagulopathy and elevation of muscular enzymes creatine-kinase and myoglobin. The chest computer tomography was consistent with mixed pneumonia, distributed in all pulmonary segments and the case was interpreted as a severe form of SARS-CoV-2 infection, associated with acute respiratory failure and rhabdomyolysis. Upon treatment (Enoxaparin, Aspirin, Dexamethasone, Favipiravir, oxygen administered by face mask, fluid resuscitation), his condition considerably improved, along with the laboratory findings, and he was discharged, without developing acute kidney injury or other complications related to rhabdomyolysis during his admission. Conclusion. COVID-19 patients can develop rhabdomyolysis, which can result in life-threating complications.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44965368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Dumitrașcu, Mihaela Popescu, Alice Elena Ghenea, M. Carsote, A. Petca, R. Petca, F. Șandru
Coronavirus disease-2019 (COVID-19) heavily hits the human body through various and dramatic ways, and endocrine system is not an exception. Our purpose is to update the concepts around subjects diagnosed with Basedow disease (BD) before, after or during experiencing COVID-19 infection. This is a literature review based on full-length, English papers that are available through PubMed (published between 2020 and 2021). Angiotensin converting enzyme 2 and transmembrane protease serine 2 receptors are expressed at thyroid level and this might explain why an active coronavirus infection activates the BD especially in patients with a potential predisposition. Also, the new diagnostic of BD might follow a COVID-19 infection (within weeks). Simultaneously dealing with both conditions requires a more challenging multidisciplinary management, while the diagnostic of thyroid condition after recovery from infection is more likely to follow the general pattern of evolution (as seen in non-COVID-19 cases). A previous diagnostic of autoimmune hyperthyroidism means mostly either: BD is remitted after prior medication treatment with anti-thyroid drugs and/or radioiodine therapy (normal thyroid function), the patient has iatrogenic hypothyroidism that was induced after thyroidectomy or after radioiodine therapy (requiring daily oral levothyroxine substitution) or the subject is under thiamazol (or similar drugs) with either controlled or uncontrolled thyroid function. Most of the clinical studies agree (but not all) that people with treated hypothyroidism and hyperthyroidism are not susceptible to a higher morbidity or mortality concerning coronavirus infection. One exception is concurrent medication with anti-thyroid drugs with a higher risk of agranulocytosis which is a prone condition to any kind of infection. Graves’ ophthalmopathy may be synchronous or not with an active thyroid disease. Except for mild forms, typically the condition requires glucocorticoid therapy, preferably a short course of intravenous methylprednisolone which exposes the patient to a higher risk of an infection, including COVID-19. Recently, BD was suspected to be induced or aggravated by COVID-19 vaccination which is still a matter of discussion.
{"title":"COVID-19 and Basedow disease","authors":"M. Dumitrașcu, Mihaela Popescu, Alice Elena Ghenea, M. Carsote, A. Petca, R. Petca, F. Șandru","doi":"10.37897/rjid.2021.4.4","DOIUrl":"https://doi.org/10.37897/rjid.2021.4.4","url":null,"abstract":"Coronavirus disease-2019 (COVID-19) heavily hits the human body through various and dramatic ways, and endocrine system is not an exception. Our purpose is to update the concepts around subjects diagnosed with Basedow disease (BD) before, after or during experiencing COVID-19 infection. This is a literature review based on full-length, English papers that are available through PubMed (published between 2020 and 2021). Angiotensin converting enzyme 2 and transmembrane protease serine 2 receptors are expressed at thyroid level and this might explain why an active coronavirus infection activates the BD especially in patients with a potential predisposition. Also, the new diagnostic of BD might follow a COVID-19 infection (within weeks). Simultaneously dealing with both conditions requires a more challenging multidisciplinary management, while the diagnostic of thyroid condition after recovery from infection is more likely to follow the general pattern of evolution (as seen in non-COVID-19 cases). A previous diagnostic of autoimmune hyperthyroidism means mostly either: BD is remitted after prior medication treatment with anti-thyroid drugs and/or radioiodine therapy (normal thyroid function), the patient has iatrogenic hypothyroidism that was induced after thyroidectomy or after radioiodine therapy (requiring daily oral levothyroxine substitution) or the subject is under thiamazol (or similar drugs) with either controlled or uncontrolled thyroid function. Most of the clinical studies agree (but not all) that people with treated hypothyroidism and hyperthyroidism are not susceptible to a higher morbidity or mortality concerning coronavirus infection. One exception is concurrent medication with anti-thyroid drugs with a higher risk of agranulocytosis which is a prone condition to any kind of infection. Graves’ ophthalmopathy may be synchronous or not with an active thyroid disease. Except for mild forms, typically the condition requires glucocorticoid therapy, preferably a short course of intravenous methylprednisolone which exposes the patient to a higher risk of an infection, including COVID-19. Recently, BD was suspected to be induced or aggravated by COVID-19 vaccination which is still a matter of discussion.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42561343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Mangaloiu, M. Rădulescu, A. Orfanu, C. Tilișcan, S. Aramă, A. Vișan, V. Aramă
Since WHO declared COVID-19 a pandemic, globally more than 212-million people were infected and approximately 4.4 millions died (25 August 2021). As the pandemic evolved, it became clear that there are many more things to research and discover about the SARS-CoV-2 infection. Besides the fact that SARS-CoV-2 primarily affects the respiratory system, more and more articles indicate a systemic involvement which could be responsible for long term consequences. The aim of this review was to evaluate the long- term signs and symptoms of COVID-19 infection. We looked for information regarding the prevalence and persistence of symptoms associated with COVID-19 infection and the persistence of organ dysfunction beyond the acute phase. We also searched data regarding the impact of the infection on the quality of life, physical, mental and psychosocial function. Recent studies have shown that some symptoms can persist a long time after the acute episode of COVID-19. Furthermore, organ sequalae can be present after the acute episode. The most common symptoms of “long COVID” are: fatigue and shortness of breath, lack of taste/smell, cough, myalgia and arthralgia, headache. Also, cardiac abnormalities, cognitive impairment, insomnia, anxiety and concentration issues can be present.
{"title":"Post discharge outcomes of patients with coronavirus disease (COVID-19)","authors":"D. Mangaloiu, M. Rădulescu, A. Orfanu, C. Tilișcan, S. Aramă, A. Vișan, V. Aramă","doi":"10.37897/rjid.2021.4.1","DOIUrl":"https://doi.org/10.37897/rjid.2021.4.1","url":null,"abstract":"Since WHO declared COVID-19 a pandemic, globally more than 212-million people were infected and approximately 4.4 millions died (25 August 2021). As the pandemic evolved, it became clear that there are many more things to research and discover about the SARS-CoV-2 infection. Besides the fact that SARS-CoV-2 primarily affects the respiratory system, more and more articles indicate a systemic involvement which could be responsible for long term consequences. The aim of this review was to evaluate the long- term signs and symptoms of COVID-19 infection. We looked for information regarding the prevalence and persistence of symptoms associated with COVID-19 infection and the persistence of organ dysfunction beyond the acute phase. We also searched data regarding the impact of the infection on the quality of life, physical, mental and psychosocial function. Recent studies have shown that some symptoms can persist a long time after the acute episode of COVID-19. Furthermore, organ sequalae can be present after the acute episode. The most common symptoms of “long COVID” are: fatigue and shortness of breath, lack of taste/smell, cough, myalgia and arthralgia, headache. Also, cardiac abnormalities, cognitive impairment, insomnia, anxiety and concentration issues can be present.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48600245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ruxandra-Patricia Nitica, B. Cimpoca-Raptis, N. Gică, Mihaela Demetrian, A. Ciobanu, R. Botezatu, C. Gică, G. Peltecu, A. Panaitescu
Varicella-zoster virus is a herpes virus that causes mild to moderate disease when primary infection (chickenpox) is acquired in childhood, but leading to great morbidity and mortality in adults, with even more complications in pregnant women. As a physiologic adaptation in pregnancy that diminishes the possibility of fetal rejection, the altered maternal immune system is the reason why complications are more frequent in this segment of adult population. Moreover, a great concern is represented by the risk of vertical transmission to the fetus that can lead to congenital varicella syndrome (CVS) in the first 2 trimesters or to neonatal varicella if the mother develops the illness perinatally. Antiviral treatment reduces the gravity of the clinical manifestations, but the existent data shows that it doesn’t influence the rate of fetal transmission. Immunoglobulin anti-VZV (VZIG) can be given as prophylaxis when there has been described contact with the virus. Vaccination should be offered to all non-immunized women at the prenatal visit to diminish the maternal and fetal risks in case of subsequent exposure. The purpose of this review is to update the current understanding regarding the best management of varicella infection in pregnancy, based on the latest data from literature and guidelines. An electronic research for relevant reviews and articles published in the last 5 years was made, using PubMed, Medline, Cochrane Data Base, and also the current international guidelines promoted by the Obstetrics and Gynecology Societies in Canada, United States, Ireland and United Kingdom. The importance of prenatal detection of non-immunized women by serologic testing for varicella antibodies should not be overlooked, and subsequent vaccination should be advised to lower the significant complications associated with developing the disease in pregnancy. In case of varicella infection in pregnancy, adequate treatment should be immediately initiated with immunoglobulin and antivirals. Careful follow-up with serial fetal echography should assess if there are abnormalities of fetal development consistent with congenital varicella syndrome. Future mothers need to be advised about the probability of vertical transmission and the associated fetal malformations. Future consideration must focus on identifying the woman at childbearing age at risk and facilitate the vaccination.
{"title":"Varicella-zoster virus infection and pregnancy","authors":"Ruxandra-Patricia Nitica, B. Cimpoca-Raptis, N. Gică, Mihaela Demetrian, A. Ciobanu, R. Botezatu, C. Gică, G. Peltecu, A. Panaitescu","doi":"10.37897/rjid.2021.s.4","DOIUrl":"https://doi.org/10.37897/rjid.2021.s.4","url":null,"abstract":"Varicella-zoster virus is a herpes virus that causes mild to moderate disease when primary infection (chickenpox) is acquired in childhood, but leading to great morbidity and mortality in adults, with even more complications in pregnant women. As a physiologic adaptation in pregnancy that diminishes the possibility of fetal rejection, the altered maternal immune system is the reason why complications are more frequent in this segment of adult population. Moreover, a great concern is represented by the risk of vertical transmission to the fetus that can lead to congenital varicella syndrome (CVS) in the first 2 trimesters or to neonatal varicella if the mother develops the illness perinatally. Antiviral treatment reduces the gravity of the clinical manifestations, but the existent data shows that it doesn’t influence the rate of fetal transmission. Immunoglobulin anti-VZV (VZIG) can be given as prophylaxis when there has been described contact with the virus. Vaccination should be offered to all non-immunized women at the prenatal visit to diminish the maternal and fetal risks in case of subsequent exposure. The purpose of this review is to update the current understanding regarding the best management of varicella infection in pregnancy, based on the latest data from literature and guidelines. An electronic research for relevant reviews and articles published in the last 5 years was made, using PubMed, Medline, Cochrane Data Base, and also the current international guidelines promoted by the Obstetrics and Gynecology Societies in Canada, United States, Ireland and United Kingdom. The importance of prenatal detection of non-immunized women by serologic testing for varicella antibodies should not be overlooked, and subsequent vaccination should be advised to lower the significant complications associated with developing the disease in pregnancy. In case of varicella infection in pregnancy, adequate treatment should be immediately initiated with immunoglobulin and antivirals. Careful follow-up with serial fetal echography should assess if there are abnormalities of fetal development consistent with congenital varicella syndrome. Future mothers need to be advised about the probability of vertical transmission and the associated fetal malformations. Future consideration must focus on identifying the woman at childbearing age at risk and facilitate the vaccination.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48929020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Ciocârlan, C. Gică, R. Botezatu, N. Gică, Mihaela Demetrian, G. Peltecu, A. Panaitescu
Since it was first associated with microcephaly and other central nervous system abnormalities, Zika virus infection emerged as a global health issue and discouraged pregnant women from traveling to areas affected by the Zika virus. Zika virus can be transmitted from mother to fetus during pregnancy, and can cause microcephaly, and other congenital malformations, known as congenital Zika syndrome. Microcephaly is determined by loss of brain tissue and abnormal brain development, and the outcome in children may vary, depending on the extent of the damage. Congenital Zika syndrome includes a broad spectrum of malformations, like limb contractions, increased muscle tone, eye abnormalities and hearing impairment. The purpose of this study is to synthesize available information about Zika virus and its impact on pregnancy and fetal development.
{"title":"Zika virus and the impact on pregnancy","authors":"M. Ciocârlan, C. Gică, R. Botezatu, N. Gică, Mihaela Demetrian, G. Peltecu, A. Panaitescu","doi":"10.37897/rjid.2021.s.15","DOIUrl":"https://doi.org/10.37897/rjid.2021.s.15","url":null,"abstract":"Since it was first associated with microcephaly and other central nervous system abnormalities, Zika virus infection emerged as a global health issue and discouraged pregnant women from traveling to areas affected by the Zika virus. Zika virus can be transmitted from mother to fetus during pregnancy, and can cause microcephaly, and other congenital malformations, known as congenital Zika syndrome. Microcephaly is determined by loss of brain tissue and abnormal brain development, and the outcome in children may vary, depending on the extent of the damage. Congenital Zika syndrome includes a broad spectrum of malformations, like limb contractions, increased muscle tone, eye abnormalities and hearing impairment. The purpose of this study is to synthesize available information about Zika virus and its impact on pregnancy and fetal development.","PeriodicalId":53394,"journal":{"name":"Revista Romana de Boli Infectioase","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48450756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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